A comprehensive guide on different types of cholesterol

To understand different types of cholesterol, it is very important to first understand what cholesterol is and what its role is in our body.

What is cholesterol?

Cholesterol is universally present in all eukaryotic cells, in their plasma membrane. It is a fat-like substance which is present in the bloodstream and is also present in body organs. There are various types of cholesterol, but generally it is mentioned as total serum cholesterol, which signifies the total amount of cholesterol present in the serum. 

Cholesterol is present in tissues and in plasma, either as free cholesterol or as combined with a long chain fatty acid, this form is a storage form. If we talk about transportation of cholesterol in the body, it is transported via plasma. It enters the bloodstream, and as mentioned is present in 2 forms in the plasma. Both of these forms, i.e Free or combined, are transported in lipoprotein. Lipoproteins are the substances which are made up of fat and proteins, that carry cholesterol through the bloodstream. There are two main types of lipoproteins- high-density lipoprotein (HDL), also known as ‘good cholesterol’ and low-density lipoprotein (LDL), also known as ‘bad cholesterol’. We will discuss these further, later in the article. 

Facts about Cholesterol:

Do you know that cholesterol is an amphiphilic lipid? Well, it contains both hydrophilic and hydrophobic parts in it. Furthermore, this nature of cholesterol makes it an essential structural element of cell membranes. It also forms the outer layer of plasma lipoproteins. 

Now, you think that how exactly is cholesterol synthesised in our body? Well, it is synthesised in many tissues present in our body, from acetyl Co-A. Acetyl Co-A is the precursor of not only cholesterol but also many other steroids in our body. 

Sources of different types of cholesterol:

We just got to know that cholesterol can be synthesised in our body, and the process is the same for animals as well. Cholesterol is present in all eukaryotic cells and therefore, it is the result of animal metabolism. It occurs in food sources of animal origin such as egg yolk, meat and liver. 

Before discussing different types of cholesterol, let’s first try to understand what role does cholesterol play in our body:

Functions of different types of cholesterol:

• The main function of cholesterol is to maintain the integrity of the cell membrane.
• It also serves as the precursor for the synthesis of many substances that are important for human survival such as vitamin D, steroid hormones.
• One of the most important roles of cholesterol is that it helps in the production of bile salts in the liver.

Different types of cholesterol:

Lipids are bound to proteins as lipoproteins for transportation in the blood. The lipids consist of total cholesterol, LDL and HDL cholesterol levels, and triglycerides. 

Cholesterol

Total blood (or serum) cholesterol

Two main types of lipoproteins carry cholesterol to and from cells. One is low-density lipoprotein or LDL and the other is high-density lipoprotein or HDL. 

HDL cholesterol

HDL, also known as good cholesterol, acts as scavenger or a hunter or a collector, carrying LDL cholesterol away from the arteries and back to the liver for disposal. This is one of the main reasons why high density lipoprotein cholesterol is k/as good cholesterol. Moreover, a healthy HDL cholesterol level may protect against heart disease and stroke. 

Why is HDL cholesterol considered to be heart healthy?

You must have come across many statements claiming that HDL cholesterol is good cholesterol and is also heart healthy. It is actually true. The mechanism behind this is that LDL tends to flow to arteries and it tends to collect over there, forming a clog. Through the time, debris, fat cells, platelets along with LDL cholesterol accumulate in the arteries. This accumulation makes arteries narrow and it becomes difficult for the blood to flow through the artery. Over time, this accumulation may completely block the passage, making it impossible for the blood to flow. This whole condition is known as atherosclerosis.

If the artery is blocked, the blood won’t be able to reach the part of the body, which that particular artery is catering to. In such conditions, the cells, or the part of the body to which blood is not able to reach, becomes deprived of oxygen and stops functioning, resulting in the death of the cell or the part of the body. 

Now, to make it easier to understand, HDL helps in preventing the accumulation of the LDL, debris, platelets etc in the arteries. By doing so, HDL prevents atherosclerosis and promotes heart health. 

According to a cohort study, it is estimated that the annual number of deaths from CVDs (Cardiovascular diseases) in India is projected to rise from 2.26 million (1990) to 4.77 million (2020). This shows just double numbers. Heart disease is escalating in India and it is the need of the hour to focus on how to prevent and treat heart diseases.

Talking about HDL, low levels of HDL cholesterol increases the risk of heart disease. People with high blood triglycerides usually also have lower HDL cholesterol. 

Factors that can affect HDL cholesterol are: genetics, type 2 diabetes, smoking, being overweight and being sedentary negatively affects HDL cholesterol levels in serum.

It is observed that women tend to have higher levels of HDL cholesterol than men.

LDL cholesterol

LDL cholesterol is also k/as bad cholesterol, as it contributes to fatty build-ups in arteries causing atherosclerosis. As discussed above, this raises the risk for heart attack, stroke and peripheral artery disease. A low LDL level is considered to be good for heart health. 

What can cause high levels of LDL cholesterol in the body?

Well, firstly, a diet rich in saturated fats and trans fat is unhealthy because it tends to raise LDL cholesterol. A low level of HDL cholesterol also raises LDL cholesterol in our body. 

Classification of LDL, HDL, Total cholesterol (mg/dl), according to ATP III (Adult Treatment Panel) Classification

LDL Cholesterol
<100	Optimal
100-129	Above optimal
130-159	Borderline high
160-189	High
More than equal to 190	Very high
Total Cholesterol
<200	Desirable
200-239	Borderline high
More than equal to 240	High
HDL Cholesterol
<40	Low
More than equal to 60	High

How we can really increase good cholesterol and reduce bad cholesterol in our body.

The most efficient way to increase good cholesterol and reduce bad cholesterol is through diet. Your food choices say a lot about your body. If you learn to choose what is best for you, then you can govern your health to a certain level.

But diet alone may not provide you with the results that you aim for, you need to get moving, start staying active, and boost your physical fitness. Diet and exercise can really help you to reduce your bad cholesterol and even it reduces your risk of CVDs. 

Understand better about how to prevent heart disease with a detailed step guide!

Lifestyle modification is the key to lead a healthy life. But how can you really modify your lifestyle? 

Well, 1) try to be more fit

2) Practice mindful eating

3) Stop smoking 

4) Drink alcohol in moderation

5) Practice meditation

6) Lose excess weight

Let’s now further understand how can we really increase good cholesterol and reduce bad cholesterol

Diet:

Many studies have shown that a Mediterranean diet with high servings of fruits and vegetables and consumption of low fat milk and milk products, can really aid in reducing bad cholesterol in your body. 

What changes do you need to make in your diet?

• Consume around 5-6 servings of fruits and vegetables daily
• Consume low fat milk and milk products, such as buttermilk, fat-free milk etc.
• Make sure to reduce the intake of saturated fats and completely avoid trans fat.
• Include sources of healthy fats in your diet such as MUFA (mono-unsaturated fatty acids) and PUFA (poly-unsaturated fatty acids). Examples of MUFA and PUFA include rice bran oil, olive oil, sunflower oil, safflower oil, soybean oil, etc.
• Include a serving of nuts in your diet such as 4 almonds, 1 walnut, etc.
• Consume whole grains as compared to refined grains.
• In the similar manner, make sure to consume whole cereals such as wheat, millets, rice, as compared to refined cereals such as refined wheat flour.

There is generally a controversy about whether to consume eggs if you have high cholesterol.

So, are eggs good or bad for your cholesterol?

Many studies have shown that the cholesterol in eggs does not tend to increase or raise the serum cholesterol. In Fact eggs can be eaten as a part of a healthy diet that is rich in fibre and low in saturated fats. Eggs do not increase the risk of dyslipidemia. 

The fats that you should focus on are saturated fats. Furthermore, the sources of saturated fats include ghee, butter, coconut oil, etc. Moreover, if you have a deranged lipid profile, make sure to limit your intake of saturated fats and avoid trans fats.

Therefore, it is very important to focus on what kind of fats you are consuming in your daily life. 

Some tips to choose good fats:

• Use more and more PUFA and MUFA sources in your diet.
• Avoid processed foods and foods high in fats, sugar and salt, such as biscuits, cookies, chips, pickles etc.
• Always read the food labels for the amount of saturated fat and for trans fat. If you make reading labels a habit, you’ll always be able to make a wise food choice while doing grocery shopping.
• Use a non-stick pan and utensils to prepare food, so that the amount of oil/fat used to prepare a meal is minimum.
• Use combinations of oils while cooking.

Exercise:

It is very important to get moving. Exercise can not only reduce bad cholesterol, also may aid in raising HDL cholesterol. A moderate intensity of physical activity for about 30-40 minutes for 5-6 days a week can really help you reduce your LDL cholesterol. 

What kind of exercises can you opt for?

• Go for a brisk walk
• Opt for running, jogging, or cycling.
• You can do aerobic or cardiovascular exercises.
• If suited, you can do resistance training as well.

Make sure to give your body a recovery period after workout. 

Quit smoking

It is observed that by quitting smoking you can reduce the bad cholesterol in your bloodstream and improve HDL cholesterol.

Studies show that smoking can make LDL or as you say bad cholesterol, a bit stickier. Which makes LDL stick to the artery wall and make the build-up known as plaque. This plaque further leads to atherosclerosis. 

On the other hand, quitting smoking can increase HDL cholesterol which further reduces LDL cholesterol. 

So, take a wise step, and quit smoking for good heart health.

Losing extra weight

You might wonder what is the relationship between cholesterol and weight? Well, weight does have a significant effect on cholesterol. Losing weight can help you reduce cholesterol. According to the American Heart Association, high cholesterol can affect people with any weight. But being overweight or obese adds extra burden, as it further increases the LDL cholesterol and decreases HDL cholesterol.

Do you know that, Every 5 kgs you are overweight, causes your body to produce as much as an additional of 10 milligrams of cholesterol per day. 

Source: https://www.webmd.com/cholesterol-management/cholesterol-and-weight#:~:text=Every%2010%20pounds%20you’re,of%20heart%20disease%20and%20diabetes.

Apart from these lifestyle changes, if you suffer from hypercholesterolemia, medications can help you as well. But these medications must be taken under the consultation of your doctor. 

Bottom line:

Though we need cholesterol to perform certain important functions in our body, excess of cholesterol is harmful for our heart health. LDL cholesterol causes build-up of plaque in our arteries leading to atherosclerosis. Moreover, the effect of high cholesterol is not limited to this, you may suffer from other cardiovascular diseases and manifestations of CVDs. 

Make sure to keep a balance between HDL and LDL cholesterol to promote heart health. 

Also, if you have a deranged lipid profile, you should always consult a doctor before following any kind of diet or before taking any kind of drugs and supplementation. 

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